The Centers for Medicare & Medicaid Services March 11 issued guidance to state survey agency directors clarifying and reinforcing the roles and responsibilities of organ procurement organizations and hospitals in organ procurement and transplantation. The guidance reaffirms hospitals’ role in caring for patients in accordance with each patient’s end-of-life wishes and emphasizes the need for discretion and sensitivity in working with patients and families. The guidance further affirms that the discussion and decision to withdraw life support should be between a patient’s family or legal representative and the attending physician. Furthermore, the guidance notes that a subsequent declaration of death is the sole responsibility of the patient’s physician and not the OPO. The guidance also reminds hospitals that to comply with Medicare Conditions of Participation, hospitals must have clear and specific policies for all aspects of the organ procurement and transplant process and must ensure their policies are based on accepted medical standards and carried out with the utmost respect for patients and families.

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